肩関節包内神経及び腋窩神経におけるRenaut小体の意義

慢性神経圧迫との関連

抄録

Pathological degeneration of the nerves in the shoulder joints was recognized during investigation of the nerves in the shoulder joint capsules and axillary nerves in human cadavers. Histological features of the nerves were 1)thickening of the perineurium,2)myxoid degeneration in the endoneurium, and 3)the presence of Renaut bodies (RB) interpreted as sequelae of chronic nerve compression. In this study, we estimated the prevalence and clinicopathological significance of RB.
Thirty-five shoulder joint capsules were obtained from 20 autops y cases (12 men and 8 women). From the 10 shoulder joints of 5 other cadavers, the axillary portion of the brachial plexus and the shoulder joint capsules were removed en bloc. Ten μm paraffin embedded sections were stained with antibodies against S-100 protein by the ABC method and nerves in the capsule were identified. Sections were selected, based on evidence of nerve degeneration and stained immunohistochemically using antibodies against EMA.
Most of the R B were found in the inferior portion of capsules. Existence of RB was recognized in 13of 20 cases. Degenerated nerves were observed on 90 of 1120 slices.32.3% of the degenerated nerves included RB following perineurial thickening. On examination of the axillary nerves, pathologic nerve changes were found only at the teres minor branches in all 10 cases. Some cells in RB were stained by antibody against EMA.
It is possible tha t the traction force in addition to the compression might affect the inferior portion of the joint capsules and axillary nerves during shoulder movement because of a high incidence of RB. We speculated that perineurium and perineurial cells seem to be concerned with the formation of RB.